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Inner Fat May Predict Heart Disease Risk
Oct. 14, 2004 -- A high amount of deep belly fat appears to be a strong risk factor for metabolic syndrome, which greatly increases heart disease risk.
The preliminary study shows that fat inside the body -- that which can't be seen or "pinched" -- is the strongest among a set of signs that predict metabolic syndrome, a set of signs known to increase heart disease risk.
But finding the excess fat requires expensive imaging techniques. And researchers warn that selectively removing it from around internal organs with diet, exercise, or other methods cannot yet be reliably done.
The study was presented at the 23rd Annual American Medical Association Science Reporters Conference in Washington.
Metabolic syndrome nearly triples heart disease risk. The condition shows up in 50% to 60% of obese adults, about 10 times the rate seen in nonobese persons. But recent research has shown that even normal-weight people can have metabolic syndrome.
Doctors already know that location of body fat can help predict heart disease risk. Heart disease risk factors tend to be fewer in adults who look "pear-shaped" because most of their fat is stationed around the hips and higher in "apple-shaped" persons with more fat around the waist.
Researchers looked at 58 post-menopausal obese women, about half of whom met criteria for metabolic syndrome because they had a combination of large weight circumference, high blood pressure or cholesterol, high blood sugar, or other factors.
They found that women with metabolic syndrome had on average 33% more fat around their abdominal organs than women free of metabolic syndrome, as measured by MRI scans. The increase in so-called "intra-abdominal fat" was invisible to doctors without the imaging since overall body weight, waist size, and fitness level were no different between the groups with and without metabolic syndrome.
The research is due out next month in the Journal of Clinical Endocrinology and Metabolism.
Strongest Predictor of Metabolic Syndrome
High internal fat was the strongest predictor of metabolic syndrome, though researchers found that signs of inflammation in the blood and the amount of lean muscle in the body were also factors, says Barbara J. Nicklas, PhD, an associate professor at the Wake Forest University School of Medicine in Winston-Salem, N.C.
"It was the most important physical characteristic identified," Nicklas said at a science reporters' conference sponsored by the American Medical Association.
She added that "it's a little bit early to tell for sure" if internal fat will prove to be a reliable predictor of metabolic syndrome.
If the results are confirmed, it remains to be seen what doctors and patients could actually do about it. There is no proven reliable way for patients to lose fat from inside the abdominal wall, and procedures such as liposuction are only used for fat under the skin.
"When people lose weight they typically lose it from everywhere," Nicklas says.
That raises a question as to whether the expensive imaging technique needed to find the internal fat will be worth the cost if no remedy is available. "It would be worth it if we can find a way to selectively treat intra-abdominal fat," she says.
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